| The study of remedies through comparison can’t
be underestimated. The final selection of the ‘similimum’
has to be fished out through discrimination. Apparently many remedies
appear similar and they need to be differentiated at large. This
is true not only in acute cases but also in chronic cases. The acute
cases demand a quick action of right order and the comparative study
becomes an imperative one to unlock a case.
Three frequently indicated ‘acute’ remedies- Aconite,
Belladonna and Arsenicum alb. with their distinct
energy patterns are discussed here through a differential world
of materia medica.
Aconite: The storm
We begin with Aconite, a storm remedy indicated in the
first stage, first few hours, first stage of inflammation. The episode
occurs suddenly, becomes fierce and goes to the peak where certain
characters are thrown on the screen. The mind with fear –
fright – anxiety state accompanied with restlessness and a
degree of panic comes into play very strongly. The mind is almost
paralyzed with fear. Belladonna and Arsenicum need
to be differentiated from Aconite as they share the ‘storm’as
well but there are distinct differences.
Aconite and Belladonna : The Stormy Cognates
Aconite is like Belladonna but without its raving,
grizzling, grumpiness, violent temper and excitability. Retrospectively,
Belladonna is like Aconite but without its anxiety,
restlessness and fear of death. Both represent the overwhelming
state where the patient may become critically ill in a few hours
but they do differ at the level of presentation.
Both act on the circulatory system. Aconite acts here through
two ways:
- Congestive erethism manifested in flushing of face, hard and
rapid pulse, etc.
- Febrile erethism preceding a general inflammatory stage without
specific localization.
A few more characteristics of Aconite are-
- Sudden hyperthermia, which often starts off with bouts of shivering.
- Red, dry skin without perspiration.
- Intense thirst for large quantities of cold water.
- One cheek red, the other pale.
In Belladonna too we get a congestive erethism. It is
due to two alkaloids – hyoscyamine and atropine. In Aconite
it is due to a toxic alkaloid Aconitine. Both have redness
and dryness, but Belladonna has them more intensely than
Aconite . Hot perspiration accompanies the condition in Belladonna
while absence of perspiration typifies Aconite . The onset
of perspiration, however, relieves Aconite but not Belladonna
. Belladonna ’s redness is brighter than Aconite
's in view of the dilatation / hyperemia caused by Atropine. Aconite
has heat of the whole body. It may be hot centrally, but cold peripherally.
Hyperpyrexic states are often accompanied by offensive foot sweat
in Aconite too, but this is not a feature of Belladonna
. Thirstlessness is a strong feature of Belladonna, though
Belladonna desires lemon drinks while Aconite desires
bitter drinks. Aconite is worse at 11p.m. while Belladonna
at 3 p.m.
Sensitivity pattern
All senses are heightened and easily aggravated in Belladonna
and Aconite . Belladonna has acute senses; he is hyperesthesic,
hypersensitive to sensory stimuli like light, noise, touch, jolts,
sun, cold air etc. and is better with rest while Aconite
doesn't feel better with rest and is restless even while resting.
The illness tells upon the taste organ in that every food or even
drinks tastes bitter except water while Belladonna has a
bad taste and offensive breath.
The sensitivity pattern is exhibited in Belladonna more
at CNS level. Belladonna has a disrupted nervous system accompanied
by mental disturbances. The patient exhibits a delirious state,
which is different from Aconite . It is the tubercular miasmatic
activity, which develops heightened sensitivity and susceptibility,
bringing all sense organs into play. Hence ample stimuli and expressions!
Family Characteristics
Bell comes from the Solanaceae family. This family includes
the remedies like Hyoscyamus, Stramonium, Dulcamara,
Capsicum, Tabacum, etc. The central theme of the
Solanaceae family is an affinity for the head / brain. Head / brain
becomes the target. Headache accompanies Belladonna Symptoms
most frequently. This can be functional or structural. Belladonna
pathogenesis ranges from simple headache to migraine, from a mere
congestion to violent inflammatory pathology viz. meningitis, encephalitis,
etc. The erethistic action on brain induces commotion, spasms, tremors
and convulsions.
Aconite is a member of the Ranunculaceae family. This family has
Helleborus, Ranunculus bulbosus, Pulsatilla, Cimicifuga, Staphysagria,
etc. as the members. The core features of this family are shock,
excitement, distress, suddenness, panic and painfulness.
A qualitative difference between the above families will make it
clear as to the indications of Aconite and Belladonna
.
Pains
Aconite has acute, sudden, unbearable pains that alternate with
feelings of either numbness or ‘pins and needles.’ Belladonna
has throbbing, pulsating, burning and bursting types of pain. Both
have abrupt beginning and abrupt ending pains. A strong feeling
of heat and redness accompany pains in both, but Belladonna
has them more intensely.
Overlapping and Recognition
Aconite and Belladonna share similarity to a great extent,
making the choice difficult. The study of body language will help
to differentiate. Aconite patients will approach a physician
with an anxious and panicking face; they will be agitated and restless,
impatient and tossing. Belladonna will approach with anger
and irritability; the eyes will be fierce and dilated. The language
used by Belladonna may be abusive. Because all senses are
heightened, Belladonna can’t tolerate sensory input
and he is intolerable to others.
Belladonna follows Aconite when the shift has occurred from
anxiety – fear – panic – restlessness to anger
– irritability – violence. Physically, once the sweating
has begun after Aconite , it is better to switch over to
Belladonna . Aconite goes for more general / systemic
reaction while Bell accentuates on early localization.
Look for different remedy if …
Aconite :
- The symptoms are not sudden
- The symptoms are not intense
- There is a lingering state
- The patient is quiet and relaxed
- Not averse to touch
Belladonna :
- Slow onset
- The symptoms are not intense
- Ongoing, chronic condition
- Fear of death
- Calm with quiet mental state
Aconite and Arsenic-alb : The Tossing cognates
Arsenicum shares suddenness, fear-fright-anxiety-restlessness
and acuity with Aconite . Both have a strong fear of death
but Arsenicum doesn’t predict the time of his death
as Aconite is known to do, as he views the situation as that
of shock. The overwhelming state produces a severe panicky reaction
and he develops a convinced feeling that he is going to die at a
certain time. This state may not be actually so moribund but Aco
perceives that it is due to panic. It is a short but intense reaction
of the mind.
Ars has a definite fear of death but it comprehends the
seriousness of the disease. Once the "storm" is over,
Aconite may assume the "peace" baseline. The Arsenicum
anxiety is much deeper, coupled with restlessness and prostration.
The restlessness of Arsenicum comes in later stages when
the patient loses strength out of prostration, while the restlessness
of Aconite comes in early stages. The Arsenicum reaction
centers around an internal sense of insecurity, which he tries to
remove through seeking security outside. In comparison to Aconite
, Arsenicum is dictatorial, has a controlling nature, is
more critical and fretful and he drives everyone to do his bidding.
Physical Differentiation
Prostration
Physically Arsenicum has much more prostration than Aconite
and this is definitely out of proportion to the morbid condition.
This is due to the fact that Arsenicum is prepared from Arsenious
acid. The acid element is reflected through more damage, more destruction,
more acidity, more burning, more fetidness, hemorrhagic diathesis
and the system in the grip of an overwhelming state. Obviously Arsenicum
pathology is deeper due to strong miasmatic activity. With prostration
there is desire to move or be moved constantly. The patient is exhausted
from the slightest exertion and this exhaustion is not felt while
lying still.
Thirst
Aconite has intense thirst for large quantities of cold water while
Arsenicum has it for frequently repeated small sips of cold
water. However, it is to be noted that Arsenicum is also
listed for three marks in the Repertory for "thirst for large
quantities of water". Arsenicum , however, longs for
hot water that gives relief. (The thirst differentiation is understood
in terms of acute and chronic and the clinical stage of pathology.
In general, in the chronic state, Ars Alb is very thirsty but a
small quantity satisfies, usually warm is preferred. - ED)
Typology
Arsenicum is lean, weak and cachectic due to the acid element.
Aconite is robust, plethoric and of sedentary habits. Arsenicum
is listed under plethoric subjects too. Ars appears pale and as
if suffering horribly.
Look for a different remedy if….
Arsenic alb.:
- Calm, quiet and relaxed patient
- Suffering without complaints
- Thirstlessness
- Passive picture of illness
- Desire and tolerance for cold drinks (this is mostly in the
acute condition where there is a craving for lemonade and cold
drinks which are tolerated or vomited - Ed)
Exclusiveness
It is only Arsenicum which is fastidious, which has dreams
of sadness, of dead people and of embarrassment. It is only Aconite
which has clairvoyant dreams and sustains shock due to fright as
a cause. Biting in children is exclusive to Belladonna while
avarice is exclusive to Arsenicum and worse from music is
exclusive to Aconite .
Conclusion
An attempt has been made to differentiate between frequently indicated
acute remedies like Aconite , Belladonna and Arsenicum
. Differentiation has been attempted from Clinico-pathological,
miasmatic, non-verbal communication & conceptual angles.
Chart demonstrating characters of Aconite , Belladonna
and Arsenicum .*
| No. |
Component |
Aconite |
Belladonna |
Arsenic |
| 1 |
Onset |
Sudden |
Sudden |
Sudden |
| 2 |
Sensitivity |
+ |
+ |
+ |
| 3 |
Susceptibility |
|
|
|
| 4 |
Tissue susceptibility |
Less |
More |
More |
| 5 |
Miasm |
Psora |
Tubercular |
Syphilis |
| 6 |
Zone of illness |
Functional |
Structural |
Structural |
| 7 |
Affinity |
Mind |
Head |
Mind |
| 8 |
Pathology |
Inflammation + |
Inflammation ++ |
Destruction |
| 9 |
Pattern of
response |
Erratic |
Erratic |
Periodical |
| 10 |
Pace
of disease |
Rapid |
Rapid |
Rapid |
| 11 |
Phase of disease |
Developing |
Fully developed |
Fully developed |
| 12 |
Body language |
Panicky |
Angry |
Panicky |
| 13 |
Discharges |
Non-offensive |
Non-offensive |
Offensive |
| 14 |
Thirst |
Large quantities |
Thirst less |
Small quantities |
*This is a general chart from differentiating point of view. Individual
remedy response may vary.
Dr. Ajit Kulkarni
M.D. (Hom.)38, Bhawani Peth, Satara
E-mail: dr_ajitkulkarni@rediff.com
Ph.: +91(02162) 284286
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